Cannabis Treatment Demand Nearly Tripled in Germany Over 20 Years, With Patients Getting Older | Research

The takeaway

Cannabis-related treatment admissions in German outpatient addiction facilities grew from 7.1% to 19.9% of all cases between 2001 and 2021, with patients increasingly older and more experienced with the treatment system.

addiction treatment planners, cannabis policy researchers, public health administrators

What the researchers found

CUD is the second-most common cause for outpatient addiction treatment in Germany. The share of CUD cases rose from 7.1% to 19.9% of total caseload. First-time admissions declined from 79.6% to 55.6%. The share of clients over 35 nearly tripled (6.0% to 17.4%). Female representation rose from 15.6% to 18.1%. Treatment completion with improvement increased from 54.7% to 65.6% between 2001-2007, then marginally declined.

Why it matters

With Germany legalizing cannabis in 2024, understanding pre-legalization treatment demand trends is essential for planning services. The aging treatment population suggests current programs designed for young users may be inadequate.

The numbers in context

2001-2021 trend. CUD share: 7.1% to 19.9%. First-time admissions: 79.6% to 55.6%. Over-35: 6.0% to 17.4%. Female: 15.6% to 18.1%. Improved outcomes: 54.7% to 65.6% (2001-2007), then marginal decline. CUD is 2nd most common OACF admission cause.

How the study worked

20-year trend analysis (2001-2021) using Germany's nationwide standardized Addiction Care Statistical Service. Joinpoint regression identified significant trend changes. Analyses covered all and first-time admissions, demographics, and treatment outcomes.

What this study cannot tell us

Administrative data with possible coding changes over 20 years. Cannot distinguish between increased treatment-seeking and increased CUD prevalence. German-specific treatment system may not generalize. No data on treatment intensity or modality effectiveness.

How to read the evidence

Nationwide administrative data spanning 20 years with joinpoint trend analysis provides strong evidence on treatment demand patterns.

When this study was published

Data spanning 2001-2021 from Germany's national addiction care statistics.

The bigger picture

The declining share of first-time admissions and aging client population suggest that cannabis treatment demand increasingly involves chronic or relapsing cases rather than new users. This has implications for treatment program design worldwide.

Questions still open

Will German legalization accelerate or change these treatment demand trends?
Do current treatment programs adequately serve older cannabis patients?

Common questions

Is cannabis treatment demand increasing?

Yes. In Germany, cannabis-related treatment admissions nearly tripled as a share of all addiction treatment over 20 years, becoming the second most common reason for outpatient addiction care.

Who is seeking cannabis treatment now?

Patients are increasingly older (over-35 share tripled) and more likely to have been in treatment before (first-time admissions dropped from 80% to 56%), suggesting more chronic or relapsing cases.

Read the original research

Cannabis-related treatment demand at the eve of German cannabis legalization - a 20-years trend analysis.

European archives of psychiatry and clinical neuroscience, 275(2), 365-378

View on PubMed ↗Publisher’s paper ↗

Citation

Stampf, Alisa; Schwarzkopf, Larissa; Batalla, Albert; Feingold, Daniel; Fischer, Benedikt; Hoch, Eva. (2025). Cannabis-related treatment demand at the eve of German cannabis legalization - a 20-years trend analysis.. European archives of psychiatry and clinical neuroscience, 275(2), 365-378. https://doi.org/10.1007/s00406-024-01832-w